Childbirth related PTSD and its association with infant outcome: A systematic review. (November 2022)

• Record Type: Journal Article
• Authors: Van Sieleghem, Sofie; Danckaerts, Marina; Rieken, Rob; Okkerse, Jolanda M.E.; de Jonge, Ellen; Bramer, Wichor M.; Lambregtse - van den Berg, Mijke P.
• Is Part Of: Early human development. Volume 174(2022)
• Publication Date: 2022-11
• Subjects: CB-PTSD childbirth-related posttraumatic stress disorder -- CB-PTSD(s) childbirth-related posttraumatic stress disorder and/or symptoms; Post-traumatic stress disorders -- Parturition -- Postpartum period -- Mother-child relations -- Problem behavior -- Object attachment; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2022.105667
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Introduction: Maternal postnatal mental health problems may negatively impact child development. Postpartum research has mainly focused on the impact of maternal depression and anxiety due to their high prevalence (13–25 % and 10–18 %, respectively). However, maternal childbirth-related PTSD (CB-PTSD) could be another important risk factor in child development (estimated prevalence: 4.7 %). Objective: We investigated whether maternal CB-PTSD (symptoms) are associated with a negative mother-child relationship and/or child developmental outcome for children aged 0–5 years. Furthermore, we examined whether maternal trauma-focused therapy can positively impact mother and child outcomes. Methods: We performed a systematic review by searching three databases (Embase, Medline, PsycInfo). Search terms involved: 'birth or delivery modes', 'PTSD psychological trauma', and 'child development or child behavior'. Two independent reviewers evaluated all eligible papers. Results: Thirty-five papers (30 samples) were included and qualitatively reported. Results suggest a negative association of maternal CB-PTSD (symptoms) with mother-infant attachment and child behavior. However, confounding factors may explain this association. The evidence on associations with breastfeeding, sleeping, socio-emotional development, and weight gain is insufficient. Research investigating the effect of maternal trauma-focused therapy on a child's outcome is scarce, contradictory, and of low quality. Conclusion: This systematic review suggests that maternal CB-PTSD may be associated with an increased number of problems in mother-infant attachment and child behavior, but other domains remain scarcely investigated and methodologic issues are present (cross-sectional study design, influence of confounding variables, sample representativeness, diversity in assessment tools). Our results support a multidisciplinary approach to providing early prevention and screening of the maternal mental health state. Highlights: Maternal CB-PTSD(s) may be associated with less favorable mother-child attachment. Maternal CB-PTSD(s) may be associated with more child behavior problems. Evidence on trauma-focused therapy for CB-PTSD(s) on child outcome is of low quality. A multidisciplinary approach to identifying young families at risk is warranted. Confounding variables should be considered as possible explanatory factors.